Thyroid eye disease. An information guide

Transcription

1 TO PROVIDE THE VERY BEST CARE FOR EACH PATIENT ON EVERY OCCASION Thyroid eye disease An information guide

2 Thyroid eye disease What is thyroid eye disease? The thyroid gland is located in the neck and produces hormones which help regulate our metabolism. Some times this gland becomes over or under active due to an imbalance of the immune system which may result in thyroid eye disease. Thyroid eye disease is a disease of the tissues surrounding the eye within the bony eye socket, which is made of mostly muscles and fat. It can also affect the eyelids. It is linked strongly with smoking and tends to be worse and more aggressive in people who smoke. The precise cause of thyroid disease is not yet known. Symptoms of thyroid eye disease dry eyes due to the lacrimal gland being attacked by the immune system causing a dry gritty sensation. This in turn will increase the tear flow puffiness of the upper lid and or around the eye especially in the mornings swelling of the fatty tissues surrounding the eye and muscles that move the eye causing the eyes to protrude forwards starey eyes appearance due to the eyelids being affected which causes them to retract double vision due to the eye muscles stiffening the cornea (clear covering of the eye) may become ulcerated due to the swelling but only in severe cases. only in rare cases a deterioration in vision can occur again due to the swelling which can cause the optic nerve to become compressed. 2

3 Treatment of thyroid eye disease Firstly the thyroid function needs to be monitored and treated appropriately by an endocrinologist (a doctor that specialises in hormones). It is then necessary for an ophthalmologist (eye doctor) to treat and continue to monitor the active eye disease. eye drops such as artificial tears usually gives relief for irritation and redness. These drops are harmless and can be used as and when required using more pillows to raise the head and taking a diuretic (water tablet) at night may reduce puffiness decompression surgery is sometimes performed to reposition the protruding eyeballs back into the eye sockets only when the eye has settled immunosuppressive treatment may be used to calm down the immune system and reduce swelling behind the eyes. This can include high doses of steroid tablets, steroid injections into the eye sockets and/or radiotherapy if the starey eye is mild it will most probably get better as the eye settles down. Some people find tinted glasses help but if this is severe and persists for a long time surgery may be needed no treatment is required if you suffer from occasional double vision. If the double vision is frequent a prism lens may be added to your glasses. If this does not help squint surgery can be performed to realign the eyes if the vision is deteriorating and cannot be corrected by glasses urgent treatment is then required, as there may be a build up of pressure behind the eye. Immunosuppressive treatment or surgery may be needed to relieve the pressure over a period of one to two years the disease does burn itself out but unfortunately can leave the eyes disfigured. Cosmetic surgery 3

4 can be carried out in these cases on the NHS. All the above will be discussed with you by your ophthalmic specialist so that the best treatment is given in accordance with your own specific eye problems. Contact Telephone Numbers The Royal Oldham Hospital Eye Ward /8216 Mon, Tues, Thurs and Fri 5pm til 9am Weds after 12.30pm Urgent Care Unit (Oldham) A&E Department Fri 5pm til Mon 9am Rochdale Infirmary Eye Clinic Mon to Thurs 9am til 5pm Fri 9am til 12.30pm Eye Ward Mon to Fri 8am til 8pm (answer machine after 8pm) Urgent Care Centre Mon to Fri after 8pm Fri 8pm til Mon 9am 4

5 Fairfield General Hospital, Bury Eye outpatient dept A&E Department Mon to Fri after 8pm Fri 8pm til Mon 8am 5

6 6

7 7

8 If English is not your frst language and you need help, please contact the Ethnic Health Team on Jeżeli angielski nie jest twoim pierwszym językiem i potrzebujesz pomocy proszę skontaktować się z załogą Ethnic Health pod numerem telefonu For general enquiries please contact the Patient Advice and Liaison Service (PALS) on For enquiries regarding clinic appointments, clinical care and treatment please contact and the Switchboard Operator will put you through to the correct department / service Date of publication: December 2007 Date of review: March 2014 Date of next review: March 2017 Ref: PI_SU_405 The Pennine Acute Hospitals NHS Trust Wood pulp sourced from sustainable forests